Yu Mi-Yeon, Yeo Jee Hyun, Park Joon-Sung, Lee Chang Hwa, Kim Gheun-Ho
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea.
PLoS One. 2017 Mar 22;12(3):e0173542. doi: 10.1371/journal.pone.0173542. eCollection 2017.
Calcium polystyrene sulfonate (CPS) has long been used to treat hyperkalemia in patients with chronic kidney disease (CKD). However, its efficacy and safety profile have not been systematically explored. We investigated the long-term efficacy of oral CPS for treating mild hyperkalemia on an outpatient basis.
We performed a retrospective analysis of ambulatory CKD patients who were prescribed CPS for > 1 week because of elevated serum potassium levels > 5.0 mmol/L. Patients were divided into four groups according to the length of time that they took a fixed dosage of CPS (Group 1, < 3 months; Group 2, 3-6 months; Group 3, 6-12 months; and Group 4, > 1 year). Response was defined as a decrease in the serum potassium level (> 0.3 mmol/L) after treatment with CPS.
We enrolled a total of 247 adult patients with a basal eGFR level of 30 ± 15 mL/min/1.73 m2. All patients took small doses of CPS (8.0 ± 3.6 g/d), and serum potassium decreased in a dose-dependent fashion. Serum potassium of all patients decreased significantly from 5.8 ± 0.3 mmol/L to 4.9 ± 0.7 mmol/L with CPS treatment (P < 0.001). The response rates were 79.9%, 71.4%, 66.7%, and 86.8% in Groups 1, 2, 3, and 4, respectively. No serious adverse effects were reported during CPS administration, though constipation was noted in 19 patients (8%).
Small doses of oral CPS are effective and safe for controlling mild hyperkalemia in CKD patients over a long period of time.
聚苯乙烯磺酸钙（CPS）长期以来一直用于治疗慢性肾脏病（CKD）患者的高钾血症。然而，其疗效和安全性尚未得到系统研究。我们调查了门诊口服CPS治疗轻度高钾血症的长期疗效。
我们对因血清钾水平>5.0 mmol/L而服用CPS超过1周的门诊CKD患者进行了回顾性分析。根据服用固定剂量CPS的时间长短，将患者分为四组（第1组，<3个月；第2组，3 - 6个月；第3组，6 - 12个月；第4组，>1年）。反应定义为CPS治疗后血清钾水平下降（>0.3 mmol/L）。
我们共纳入了247例成年患者，其基础估算肾小球滤过率（eGFR）水平为30±15 mL/min/1.73 m²。所有患者均服用小剂量CPS（8.0±3.6 g/d），血清钾呈剂量依赖性下降。CPS治疗后，所有患者的血清钾从5.8±0.3 mmol/L显著降至4.9±0.7 mmol/L（P<0.001）。第1、2、3和4组的反应率分别为79.9%、71.4%、66.7%和86.8%。CPS给药期间未报告严重不良反应，不过有19例患者（8%）出现便秘。
小剂量口服CPS对长期控制CKD患者的轻度高钾血症有效且安全。
